Resuming Training After a Running Injury

If you start back up with running too soon, you could end up hurting yourself even more.

An overuse injury - one caused by too much running over a period of time without adequate rest - is one of the most frustrating afflictions a runner can endure. The moment the injury has healed is one of the most joyous of times for a runner. Or so it should be. The moment your injury has healed is also a time fraught with danger. It’s not as simple as hopping back on the road when the pain is gone.

Firstly, it’s never as clear-cut as a runner having an injury one day and not the next. Injuries heal gradually and the healing process is rarely fully complete when a runner ventures back on to the road. So how should an injured runner approach this delicate time, when coming back even slightly too early can set the individual back by weeks?

Only the individual can judge when the time is right. The instant there is no pain at all emanating from the previously injured region would seem to be an acceptable time, but waiting for that moment can leave a runner sitting around for months longer than necessary. Running with some residual pain is usually OK, but how can you tell what pain is acceptable and what will simply lead to an exacerbation of the injury? An appreciation of the healing process can help facilitate an understanding of the pain that can ensue during the comeback stage.

All physical activity leads to some degree of muscular micro tears. An injury is an excessive case of this natural process. It happens when these tears either accumulate over time without adequate daily healing, or occur rapidly (or instantaneously) during a particularly intense training session (for example, a hamstring tear from rapid acceleration).

The aftermath of a muscle tear or strain (simply a lesser version of a tear) will result in the runner’s body laying down new fibers to strengthen the region. However, this process occurs somewhat haphazardly, with new fibres growing at random angles, overlapping each other, and forming a patchwork of new tissue. This is more
commonly known as scar tissue.

As one starts to reuse the injured muscle again, the weak and poorly aligned new fibres will break apart and be reabsorbed by the body, while the properly aligned fibres will be strengthened. This is the phase whereby the scar tissue gradually shrinks away. It’s the breaking of these superfluous muscle fibres that can cause fleeting pain in the injured region. These pains are often interpreted by the runner as a sign the injury has not yet fully healed. In a sense, this is true. Yet, a sensible transit through this stage, with a gradual increase in running volume, can result in a more rapid recovery from the injury than would otherwise have been the case.

Every injury exhibits its own peculiarities. It’s simply not possible to prescribe a one-size-fits-all remedy for all injuries a runner may encounter. The injured individual must first allow adequate rest time for the injury to initially heal. Once the original pain associated with the injury subsides, a runner can start thinking about getting back on the road.

Sharp but very brief pains – akin to a pinch or pinprick – are a classic sign of a scar tissue’s superfluous fibres breaking apart. While the runner should still exercise serious caution, it can be possible to run with this sort of pain. However, if the pain is similar to that of the original injury and doesn’t subside quickly during the run, cease running and give yourself more time to recover.

Even if the pain is due to poorly aligned scar tissue breaking apart, it will still result in some further inflammation. Ice the area when you finish, and keep the distances relatively low until you can run without any pain at all. And don’t forget, if you’re unsure if the injury has truly healed, err on the side of caution. And if the pain persists or is intense, consult a doctor or physiotherapist.

Tom Denniss is an Australian athlete, scientist, and entrepreneur. He has a PhD in Mathematics and Oceanography, has invented a technology to convert the energy in ocean waves into electricity, founded a company to commercialise that technology, has played professional rugby league, and was a finalist in the 2014 Australian of the Year Award. In 2013 he set a new world record for the Fastest Circumnavigation of the Earth on Foot. Tom lives in Sydney, Australia. A former professional musician, he has played to audiences in eight countries. He has written various articles for newspapers, magazines, and journals, as well as a book about his run around the world, titled The World At My Feet. You can read more of Tom's work here.